Whenever there is a heated argument whether things were better during the USSR times, this statement invariably pops up as a mighty ace: At least they had free medical care in the Soviet Union! This is supposed to bring the opponent to the knees and make them beg mercy and forgiveness for betraying the Great October achievements.

Well well well. Let’s have a close look at what really was free then.

After the events of October 1917, the Bolsheviks chose to nationalise all hospitals and medical practices previously founded by various state and charitable organisations. This would have been a feasible plan, had they not chosen to class all doctors as “rotten bourgeois” which meant that they had to emigrate from the “Red Terror” or face death.

Even Vladimir Lenin in a letter dated of Nov 1918 wrote to an acquaintance: Please go abroad to see a doctor – they have wonderful specialists in Switzerland and Vienna… Our so-called doctors are fools.

In early 1920s various medical experiments became popular and acquired great support of the state: without much of a theoretical base or substantial research, a lot of time and money was poured into genetical experiments to breed a new type of person – of a Socialist kind.

Al in all, the years in which the Bolsheviks were starting off were very tough: the country was in a run-down state after the WWI; there was a severe famine; pandemics of cholera, typhoid, malaria; as well rising numbers of people dying of various infections and malnutrition. From a health perspective, the state of many medical practices and hospitals was borderline catastrophic. The buildings were getting old without any hopes for repair; central heating often failed; medical supplies were insufficient and irregular. The food supplies were often short, and the burial of the dead was an issue as well.

The state spending on medicine was low to start with, and it was gradually declining: it was 3.9% of the total budget in 1927; 3.6% in 1928; 3.5% in 1929 and 3% only in 1930. The severe skill shortages in the health industry were imminent, and there was a strong urban focus in health providers’ locations – given that the supply was already short, the villages were even worse off.

In the late 1920s industrialisation, as per Stalin’s orders, aimed at developing the heavier industrial machinery production – so the times which what was already bad was turning even more foul. Bureaucracy was starting to settle in, while the budget cuts continued (2.5% of the total budget in 1932, 2.7% in 1933). On paper, as often in the USSR, things looked if not rosy but at least decent: the attention was drawn to preventative measures and the importance of the population’s health; whereas in reality it was very ugly.In our old post about the life in the 1920s, the images of those time were indeed scary, if you remember.

During the Second World War, the main beneficiary of medical help was, understandably, the army – the rest of the population, fair to say, was abandoned. Various types of typhoid, TB, dysentery, malaria, cholera and even plague were not uncommon– the diseases were spreading very rapidly due to the poor supply of drugs and increasing numbers of migrants.

When the war was over, the main efforts (as well as financial means) were generated towards rebuilding the towns and getting the economy back up – and as always, there was no room for medicine research and development. The health industry salary bands were among the lowest in the country. In 1940 the doctors were earning 255 roubles per month, as compared with 399 roubles average. In 1955 it was 521 roubles against 711 average. In August 1945 a group of doctors sent an open letter to Stalin describing the abhorrent situation in the health industry. It mentioned the factory workers with high-school qualifications were earning 1300 – 1400 roubles per month, whereas the hospital manager, a doctor with 8 years of education and years of experience would be fortunate enough to earn 800 roubles.

The change was brought upon by Nikita Khrushchev, who was slowly setting new goals and getting his government to redevelop many facets of Soviet life. But the late fifties were also the times when the famous free Soviet medical care system stopped being free. The doctors became less covert in taking cash from patients in exchange for medical services, for medical supplies, for drugs. The less-qualified medical staff (nurses and caregivers) were making some extra cash by providing extra-nice services to patients – for 10 roubles per night you could have a nurse by your bed taking care of you – obviously, all other patients would have been neglected. Midwives in birthcare institutions were bribing the fathers – one would pay a one off 25 roubles for the girl and twice as much for the boy as to “take them home”.

Among the key problems were:

Alcoholism and drug use – extremely widespread.
Bad ecology – due to heavily exploited plants and factories, many towns were below par – the Southern republics, Moldavia, some parts of Ukraine, industrial central Russia and Siberia.
Food shortages – especially in the rural areas and small towns with the population of less than 100,000 people; as well as the appalling quality of food.
Extremely high rates of abortions (100 for every 1000 women in the age of 15 – 49; or 200 abortions for every 100 of births). Also, the actual procedure was a very primitive one which lead to the death of a woman in almost 25 – 30% of cases.
Health and Safety in employment – extremely high industrial accident rates
Road death tolls
Also, in early 1980s the widespread of sexually transmitted diseases started to take its toll. In 1970 more than 12% of women of reproductive age were diagnosed and treated from STD, many of whom suffered from syphilis. In 1987 the first case of HIV was registered, after which the disease had escalated to the point of people panicking.

The Soviet doctors had all the pressure to catch up with their Western counterparts, and they did their best, given the circumstances. The first successful heart transplant attempt did not happen until March 1987, which was almost 20 years after the American debut. Such a significant delay was not just due to the budget cuts and low financing – the appropriate legislative framework was missing, and so was the concept of organ donors.

This is how the free Soviet medicine had met the death of the Soviet state. It almost seems like the 70 years of the 20th century did not provide any move forward – despite the antibiotics, vaccination and hundreds of thousands of graduate doctors, the overall state of the health industry was just ever so slightly better than at the end of the Tsar times. And then, of course, the typically Soviet traits of doing things: bureaucracy, corruption, the notoriously abhorrent levels of customer service and the low priority that the state would give the health industry.

This does not deny the Soviet doctors their achievements – over the course of 70 years, there would have been plenty – but nothing was easy and nothing was certainly free.

Soviet Russia while manufacturing jet fighters and nuke subs at a faster pace than any other country in the world was unable to make enough pharmaceuticals to keep its own people healthy.

A state which was formed stating that class division should not exist. Where every service provided by govt had class divisions, the commie party higher upps used to get medicines from France and the regular soviet citizen had to treat his illness with capsules that were filled with wheat flour and tonics that had colored water. This was due to the idiotic failure of the five year plans where communist higher upps did not have the know of situation at the ground, they just made up some arbitrary figures which had to be reached by every industry. When the pharma companies did not get enough raw material, they improvised. Because of this the higher upps did not believe in the capability of Soviet medicines.

Near the end of the Soviet Russia, more than 90% of work done by KGB was in industrial espionage. Soviets were only catching up to the improvements in technology made by USA. Even with spending so much effort on Industrial spying, they could not come up to US in technical level, case in point would be the microprocessors.

some jokes told by Ronald Regan about Soviet system which were told to him by Soviets themselves.

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An oft quoted Gandhian phrase is that if all were to follow an eye for an eye and tooth for a tooth, then the world would go blind. The counter to that is that if only some follow this and others don't then it is the non-violent who would go blind while the rogues will rule the world.

Russia during tsar's time was so backward compared to the rest of Europe technologically and in manufacturing, that it took the brute force of communism to make it to come to level with the rest of Europe. Very large country with excellent natural resources and with few people helped it.

One main thing that i read helped this industrialization was the building of trans russian railway. This forced industrialization brought them to a certain point, after that it should have had to be consumer driven growth, which was never the case with communist russia.

Every thing was in a short supply, right from toilet paper to television sets. To get a good quality meat cuts one had to to know some one or have been very good with the shop keeper. Every thing used to have big lines and this was omnipresent throughout communist rule in Russia.

While russia was good at millitary industry, it always fell short in agriculture, this could be attributed to the non-existent research in biology, genetics ........

Throughout the cold war there were periods where in Soviets had to import wheat from USA.

----somemore someother time

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An oft quoted Gandhian phrase is that if all were to follow an eye for an eye and tooth for a tooth, then the world would go blind. The counter to that is that if only some follow this and others don't then it is the non-violent who would go blind while the rogues will rule the world.